HomeMy WebLinkAboutwell info - � � � - �I'zvin City �Nater CCinic, Inc.
61713th Ave So • Hopkins,Minnesota 55343 • (612)935-3556
' 11/20/1993
Stodola Well Drilling
15306 Hwy 7
Minnetonka MN 55345
938-2111
REPORT OF WATER ANALYSLS
Lab�t: 21511
Our Laboratory reports-these analytical results, determined on a sample taken
by YOU on 1 1/18/1993 from the following location:
Paui Hannsen
b40 North Arm Dr
Orono,Mn
L�vii.que.* 532607
Coliform Bacteria <1/100 ml
Nitrates Nitrogen <1.0 mg/I
The results of these tesis indicate that this weli is producing water that meets the
standards far F.H.A., V.A., or conventional loans.
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'nic, Inc.
Bill Va I
Brian BI
,
Anslyiwl labowary cooauld�g Fagincor +
Wuer Adly�u Raagea4 Boiler W�ter C6emiuV
�OFLL LC�ATION MINNESOTA DEPARTMENT OF HEALTH MINNESOTA UNIQUE WELL NO.
CountyName WELL RECORD ,�
� � �� � �
�''<'r'S�P'">Z-== Minnesota Statutes Chapter 1031 `�-% ��+ ��
Township Name Township No. � Range No. Sectioh No. Fraction WELL DEPTH(completed) Date Work Completed
C.-��'I11�. I ? , ..� , �. '� �� � a. 3�_� .���
� ;.
v. v, v.
Numerical Street Address and City of Well Location or Fire Number DRILLING METHOD
.- 1�fC1]'�i:.�s, .f�..i:;.' i3;Y'i�.''E'' (.'�ti`Tll!� T'�'s.. G CableTool ❑ Driven ❑ Dug
❑ Auger .O Rotary �] Jetted
Show exact location of well in section grid with"X". Sketch map of well location. ❑
Showing property lines,
N roads and buildings. DRILLING FLUID
I � ' '
--r--7- -1 -1- � � � '�:�
i �---
i ' � .USE ❑ Heating/Cooling
._i_ ___ �_ �_ 0-Domestic � Monitoring
yy i ; i E ❑ Irrigation ❑ Public ❑ Industry/Commercial
_1_ _s_ __ __ T ❑ Test Well ❑ Dewatering O Remedial
I , � '
� , /
�""° CASING Drive Shoe? Cj�Yes ❑ No HOLE DIAM.
--�- �- ; —r- I � ,��('. O•�Steel ❑ Threaded ❑ Welded
t 1 ❑ Plastic ❑
�—I milr�
/y /C�f"t /•T Ic I`J�°� ��I. CASING DIAMETER WEIGHT
PROPERTY OWNER'S NAME �f'�- � '•�`��%
.. .1:i .�.�r�.,t ..:P::�: in.to ft. Ibs./ft. in.to�tt.
in.to ft. IbsJft. �in.ta -� ft.
Mailing address if ditterent than property address indicated above. in.to R. Ibs./ft. in.to ft.
SCREEN�„Y,� OPEN HOLE
�
Make � from ft.to ft.
TyPe .. `Y l r#� �?5� :.il:�_'..'.� Diam. �
SIoUGauze ��' Length
Set between �:'i= ft.and_ir+x__tt. FITTINGS:
STATIC WATER LEVEL
GEOLOGICAL MATERIALS COLOR HARDNESS OF FROM TO ft. E'�be�ow ❑ above land surface Date measured { �"�� "'�' `
MATERIAL
PUMPING LEVEL(below land surface)
t��' ' ' � �: ' ft. after hrs.pumping g.p.m.
WELL HEAD COMPLETION
t`;�'?1 °L;�iL:_.Y
:•�,�,G;;i ���'..��" }�i 'O;�itless adapter manufacturer Model
❑ Casing Protection E? 12 in.above grade
GROUTING INFORMATION
Well grauted? d Yes ❑ No
Grout Material ❑ Neat cement ❑ Bentonite
from to ft. ❑ yds. Q bags
� from to fl. ❑ yds. ❑ bags
from to R. ❑ yds. ❑ bags
NEAREST KNOWN SOURCE OF CONTAMINATION
teet direction rype
Well disinfected upon completion? ��.Yes ❑ No
PUMP
11--�1 . �t�
❑ Not installed Dat��i.rfqt�M�[�_;
9 A Manufacturer's name
`t Model number . ..,� HP_�Yolts G��-
NO Length of drop pipe + ft. Capacity ``' g.p.m.
0 Pressure Tank Capacity 4i+'1�- �`"i��-'-t x''+-�-�
CType:.[] Submersible ❑ L.S.Turbine ❑ Reciprocating ❑ Jet ❑
ABANDONED WELLS
Does property have any not in use and not sealed well(s)? ❑ Yes O'�No
WELL CONTRACTOR CERTIFICATION
This weli was drilled under my supervision and in accordance with Minnesota Rules,Chapter 4725.
The information contained in this report is true to the best of my knowledge.
_. , ` �.� �1 ..:i '. ::i 1 ,_.�. `, .., , �[�� . f'i:_
Use a second sheef,il needed
REMARKS,ELEVATION,SOURCE OF DATA,eta Licenseeeusin ssName � '�Lic.orReg.No.
-..�--� __�... � � �--���--i��,
_ �� . �_
Aut oriz RepresentativeSignature ���� Date ;
_ 3'� - l 7��_:�4'C: �Z._� (;"<
Name ol Oriller Date
LOC�,L CO�Y 5 3 � �n 7 HE-01205-04(Rev.5/92)
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